Breastfeeding - Page 3

Preparing for Breastfeeding

One of the most significant changes a breastfeeding mother experiences is when her milk "comes in." With the expulsion of the placenta after a baby's birth, a drop in the hormones that maintained the pregnancy soon occurs and allows the hormone prolactin to begin to work. Prolactin "tells" the breasts it is time to begin producing large amounts of milk. A mother feels the result of prolactin when her milk comes in at three to five days postpartum.

You may notice that your breasts feel fuller, heavier, or warmer when your milk comes in. Some mothers find their breasts become uncomfortably engorged due to increased milk volume and tissue swelling. Then the breasts feel hard and tight; the areola and nipple may seem stretched and flat, making it difficult for a baby to latch-on. The most important thing to do when your milk first comes in is to move the milk out of your breasts by feeding your baby frequently. If your baby has difficulty latching on because of severe engorgement, consider the following:

Soften the nipple and areola by expressing some milk and then let baby latch on.

Breastfeed or express milk by hand or breast pump frequently (every one to two hours); your breasts should feel noticeably softer after breastfeeding or pumping.

Apply cold packs or sandwich bags filled with ice or frozen vegetables to the breasts for 20 to 30 minutes after a feeding or pumping session. The application of cold packs has been shown to relieve the swelling that may interfere with milk flow. Some women do report improved milk flow if they also apply warm compresses to the breasts for a few minutes immediately before breastfeeding or milk expression, but there are no studies that support this as effective. Using heat for more than a few minutes could increase the amount of swelling.

When my baby starts to breastfeed, I feel a tingling in my breasts and then the milk begins to flow. What is this?

A baby's effective sucking triggers a milk let-down, or the milk-ejection reflex (MER). Some mothers briefly feel a tingling, "pins and needles," or a flushing of warmth or coolness through the breasts with milk let-down; others notice nothing different, except the rhythm of baby's sucking. You may also feel uterine cramping when breastfeeding the first two or three days, especially if you have had a baby before. It also means your uterus is contracting, which helps minimize bleeding.

Some mothers have such a strong let-down that the baby cannot handle the volume of milk. If your baby chokes, gags, pushes off of the breast a minute or two after beginning to feed, an over-active let-down may be the cause. Most babies do learn to handle let-down as they mature, but until then you might take the baby off the breast until the milk flow slows. Try using only one breast each feeding. Some mothers find it helps to position the baby so that the back of his/her throat is higher than the nipple, so that the milk has to "travel" uphill during a let-down, which slows the flow. Another option is to try pumping through the let-down immediately before a feeding.